What secondary conditions are linked to Upper Extremity Amputation?

Common secondary conditions for Upper Extremity Amputation include Shoulder Condition - Contralateral, Cervical Spine Condition, Phantom Limb Pain, Major Depressive Disorder. Secondary service connection is established under 38 C.F.R. 3.310 when a condition is caused or aggravated by an already service-connected disability.

What happens during a C&P exam for Upper Extremity Amputation?

Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation. Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.

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Upper Extremity Amputation

Q: What are the VA rating percentages for Upper Extremity Amputation?

Upper Extremity Amputation (DC 5120-5156) is rated at 100%, 90%, 80%, 70%, 60%, 50%, 40%, 30%, 20%, 10% under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand. DC 5120 verbatim — Forequarter amputation (involving complete removal of the humerus along with any portion of the scapula, clavicle, and/or ribs). 100% Major AND 100% Minor (the only DC 5120 row that ties major and minor at 100). Footnote 1: entitled to SMC under 38 CFR § 3.350.

Q: What rates 100% for Upper Extremity Amputation under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand?

Under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand (DC 5120-5156), a 100% rating for Upper Extremity Amputation requires: DC 5120 verbatim — Forequarter amputation (involving complete removal of the humerus along with any portion of the scapula, clavicle, and/or ribs). 100% Major AND 100% Minor (the only DC 5120 row that ties major and minor at 100). Footnote 1: entitled to SMC under 38 CFR § 3.350.

Q: What rates 90% for Upper Extremity Amputation under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand?

Under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand (DC 5120-5156), a 90% rating for Upper Extremity Amputation requires: DC 5120-5121 verbatim — TWO pathways yield 90% (major); 80-90% (minor): (a) DC 5120 Disarticulation (involving complete removal of the humerus only) — 90 major / 90 minor. (b) DC 5121 Above insertion of deltoid — 90 major / 80 minor. Footnote 1 SMC entitlement applies.

Q: What rates 80% for Upper Extremity Amputation under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand?

Under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand (DC 5120-5156), a 80% rating for Upper Extremity Amputation requires: DC 5122-5123 verbatim — TWO pathways: (a) DC 5122 Below insertion of deltoid — 80 major / 70 minor. (b) DC 5123 Forearm amputation, Above insertion of pronator teres — 80 major / 70 minor. Footnote 1 SMC entitlement applies.

Q: What rates 70% for Upper Extremity Amputation under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand?

Under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand (DC 5120-5156), a 70% rating for Upper Extremity Amputation requires: DC 5124-5131 verbatim — Multiple pathways yield 70% major / 60% minor: (a) DC 5124 Forearm amputation, Below insertion of pronator teres. (b) DC 5125 Hand, loss of use of. (c) DC 5126 Five digits of one hand, amputation of. (d) DC 5127-5131 Four digits of one hand (any 4-digit combination involving thumb): thumb+index+long+ring, thumb+index+long+little, thumb+index+ring+little, thumb+long+ring+little, OR index+long+ring+little. Footnote 1 SMC.

Q: What rates 60% for Upper Extremity Amputation under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand?

Under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand (DC 5120-5156), a 60% rating for Upper Extremity Amputation requires: DC 5132-5141 verbatim — Three-digit amputation pathways yield 60% major / 50% minor (thumb+two-other combinations): DC 5132 thumb+index+long, DC 5133 thumb+index+ring, DC 5134 thumb+index+little, DC 5135 thumb+long+ring, DC 5136 thumb+long+little, DC 5137 thumb+ring+little. DC 5138-5141 (three non-thumb digits) rate 50/40 — see 50% tier. Footnote 1 SMC NOT typically applied at this tier.

Q: What rates 50% for Upper Extremity Amputation under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand?

Under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand (DC 5120-5156), a 50% rating for Upper Extremity Amputation requires: DC 5138-5141 + DC 5144-5147 verbatim — pathways yield 50% major / 40% minor: (a) Three non-thumb digits (DC 5138-5141: index+long+ring; index+long+little; index+ring+little; long+ring+little). (b) Two-digit amputations involving thumb (DC 5144 thumb+ring; DC 5145 thumb+little; DC 5146 index+long; DC 5147 index+ring).

Q: What rates 40% for Upper Extremity Amputation under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand?

Under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand (DC 5120-5156), a 40% rating for Upper Extremity Amputation requires: DC 5142-5151 + DC 5152 verbatim — pathways yield 40% major / 30% minor: (a) Two-digit amputations DC 5142 thumb+index, DC 5143 thumb+long. (b) DC 5152 Thumb amputation with metacarpal resection (40 major / 30 minor).

Q: What rates 30% for Upper Extremity Amputation under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand?

Under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand (DC 5120-5156), a 30% rating for Upper Extremity Amputation requires: DC 5148-5151 + DC 5152-5153 verbatim — pathways yield 30% major / 20% minor: (a) Two-digit amputations not involving thumb (DC 5148 index+little; DC 5149 long+ring; DC 5150 long+little; DC 5151 ring+little). (b) DC 5152 Thumb amputation at MCP joint or through proximal phalanx. (c) DC 5153 Index finger amputation with metacarpal resection.

Q: What rates 20% for Upper Extremity Amputation under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand?

Under 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand (DC 5120-5156), a 20% rating for Upper Extremity Amputation requires: DC 5152-5156 verbatim — single-digit amputation pathways yield 20% major / 20% minor (at this tier major+minor align): (a) DC 5152 Thumb at distal joint or through distal phalanx. (b) DC 5153 Index finger without metacarpal resection, at PIP joint or proximal thereto. (c) DC 5154 Long finger with metacarpal resection. (d) DC 5155 Ring finger with metacarpal resection. (e) DC 5156 Little finger with metacarpal resection.

DC 5120-515638 C.F.R. § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand

Diagnostic Code

DC 5120-5156

38 C.F.R. § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand

Rating Range

10–100%

10 severity tiers

Source

Verified

38 C.F.R. § 4.71a

Upper Extremity Amputation is rated by the U.S. Department of Veterans Affairs under DC 5120-5156 of 38 CFR § 4.71a DCs 5120-5156; § 3.350(a)(2) SMC-K loss of use of hand across 10 severity tiers (100% / 90% / 80% / 70% / 60%…). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303. This condition is frequently rated as secondary to Shoulder Condition - Contralateral or Cervical Spine Condition under 38 C.F.R. § 3.310.

Educational tool only. Not legal or medical advice. Not affiliated with the VA.

Overview

Surgical or traumatic loss of part or all of an upper extremity (finger, hand, arm, shoulder). Anatomic-level specific canonicals — arm-amputation-above-elbow (DC 5121), arm-amputation-below-elbow (DC 5123), hand-amputation (DC 5125), finger-amputation-thumb/index/multiple/ring/little — carry the full rating tiers with major/minor extremity tiers based on dominant-hand status. This record covers cross-cutting concerns (phantom limb pain, prosthesis-fitting issues, contralateral overuse, occupational impact, depression from functional loss).

Rating Criteria

100%

DC 5120 verbatim — Forequarter amputation (involving complete removal of the humerus along with any portion of the scapula, clavicle, and/or ribs). 100% Major AND 100% Minor (the only DC 5120 row that ties major and minor at 100). Footnote 1: entitled to SMC under 38 CFR § 3.350.

90%

DC 5120-5121 verbatim — TWO pathways yield 90% (major); 80-90% (minor): (a) DC 5120 Disarticulation (involving complete removal of the humerus only) — 90 major / 90 minor. (b) DC 5121 Above insertion of deltoid — 90 major / 80 minor. Footnote 1 SMC entitlement applies.

80%

DC 5122-5123 verbatim — TWO pathways: (a) DC 5122 Below insertion of deltoid — 80 major / 70 minor. (b) DC 5123 Forearm amputation, Above insertion of pronator teres — 80 major / 70 minor. Footnote 1 SMC entitlement applies.

70%

DC 5124-5131 verbatim — Multiple pathways yield 70% major / 60% minor: (a) DC 5124 Forearm amputation, Below insertion of pronator teres. (b) DC 5125 Hand, loss of use of. (c) DC 5126 Five digits of one hand, amputation of. (d) DC 5127-5131 Four digits of one hand (any 4-digit combination involving thumb): thumb+index+long+ring, thumb+index+long+little, thumb+index+ring+little, thumb+long+ring+little, OR index+long+ring+little. Footnote 1 SMC.

60%

DC 5132-5141 verbatim — Three-digit amputation pathways yield 60% major / 50% minor (thumb+two-other combinations): DC 5132 thumb+index+long, DC 5133 thumb+index+ring, DC 5134 thumb+index+little, DC 5135 thumb+long+ring, DC 5136 thumb+long+little, DC 5137 thumb+ring+little. DC 5138-5141 (three non-thumb digits) rate 50/40 — see 50% tier. Footnote 1 SMC NOT typically applied at this tier.

50%

DC 5138-5141 + DC 5144-5147 verbatim — pathways yield 50% major / 40% minor: (a) Three non-thumb digits (DC 5138-5141: index+long+ring; index+long+little; index+ring+little; long+ring+little). (b) Two-digit amputations involving thumb (DC 5144 thumb+ring; DC 5145 thumb+little; DC 5146 index+long; DC 5147 index+ring).

40%

DC 5142-5151 + DC 5152 verbatim — pathways yield 40% major / 30% minor: (a) Two-digit amputations DC 5142 thumb+index, DC 5143 thumb+long. (b) DC 5152 Thumb amputation with metacarpal resection (40 major / 30 minor).

30%

DC 5148-5151 + DC 5152-5153 verbatim — pathways yield 30% major / 20% minor: (a) Two-digit amputations not involving thumb (DC 5148 index+little; DC 5149 long+ring; DC 5150 long+little; DC 5151 ring+little). (b) DC 5152 Thumb amputation at MCP joint or through proximal phalanx. (c) DC 5153 Index finger amputation with metacarpal resection.

20%

DC 5152-5156 verbatim — single-digit amputation pathways yield 20% major / 20% minor (at this tier major+minor align): (a) DC 5152 Thumb at distal joint or through distal phalanx. (b) DC 5153 Index finger without metacarpal resection, at PIP joint or proximal thereto. (c) DC 5154 Long finger with metacarpal resection. (d) DC 5155 Ring finger with metacarpal resection. (e) DC 5156 Little finger with metacarpal resection.

10%

DC 5153-5156 verbatim — minor-residual single-digit pathways yield 10% major / 10% minor: (a) DC 5153 Index finger through middle phalanx or at distal joint. (b) DC 5154-5156 Long/ring/little finger without metacarpal resection, at PIP joint or proximal thereto.

03Key Evidence

—Service treatment records showing injury or complaints

—Imaging (X-ray, MRI, CT)

—Range of motion measurements

—Flare-up documentation per Sharp v. Shulkin

—Buddy statements describing limitations

—Prescription history

—Physical therapy records

—Employment impact documentation

04C&P Exam Tips

1Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.

2Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.

3Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.

4Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).

5If you use assistive devices (brace, cane), bring them.

6Describe daily activity impact: work, sleep, household tasks.

05Secondary Conditions

Shoulder Condition - ContralateralMODERATE

Overuse of remaining arm

Cervical Spine ConditionMODERATE

Asymmetric loading affects neck

Phantom Limb PainMODERATE

Neurological pain in missing limb

Major Depressive DisorderMODERATE

Adjustment to disability

Tools

Rating Calculator →Secondaries Explorer →C&P Exam Prep →PACT Act Scanner →2026 Rates →

Sources & Editorial

Rating criteria text quoted verbatim from 38 C.F.R. § 4.71a (Musculoskeletal system). Source verified 2026-05-17 by ClaimRecon Editorial Team against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.

View § 4.71a on eCFR →Cornell Law mirror →Editorial Standards →Suggest a correction →

EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026

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